Expert: Sally Wendkos Olds - 5/23/2007

Question
Hi, my baby is 14th week now. I wish to find out the average time baby of her age nurse before emptying the breast.I used to breastfeed her for about 30mins in total followed by a 30ml of expressed milk supplement. However,recently she only takes about 10mins on each side then she would fuss if I put her to breast again. She also refuse any supplement of expressed milk. I m concerned she is not getting enough. Her diaper are lighter and her lips start to show dryness. But surprisingly, baby would sleep till the next feed which seems to mean she is doing fine. What else should i look out? thanks

Answer
Dear Ruth,

First, congratulations for giving your daughter the best start in life by breastfeeding her!

Babies are all different, so the average time of nursing really doesn't mean anything. The typical baby of 14 weeks should be able to empty the breasts in 10 minutes on each side. However, since this is a change from the way that she used to nurse and since her diapers are lighter and her lips are dry, there may be a problem. The fact that a baby sleeps a lot does not necessarily mean she is getting enough nutrition. I am attaching an excerpt from my book (see below) which may help you to judge whether she is getting enough food. (Much of this applies to younger babies, and also the table may not look the same in this format, but you can probably figure it out.)

In any case, I would still urge you to take her to the doctor just to check her out, to see whether she is gaining enough weight and doing well in general.

Good luck!

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
-----------
FROM THE COMPLETE BOOK OF BREASTFEEDING:

Your baby is probably getting enough to eat if you can answer yes to all of the following questions. If you cannot, call your baby's doctor right away.

Your Baby's Urine and Stools
The evidence in your baby's diapers is the most important sign of his or her adequate milk intake.
  * Does your baby have the number, color, and size of stools described in the Table below, at the appropriate ages?
  Your baby should be having regular bowel movements in a quantity of at least 1 tablespoon (1/2 ounce) or more. After the first few days, they should be yellow and loose, with small curds. They may smell and look like yogurt, or like a mix of cottage cheese and mustard. If a baby over five days old is passing dark stools or fewer than those listed in the table, this is a sharp warning that she is probably not getting enough nourishment.
  
  JUDGING INTAKE BY OUTPUT
DAY OF BABY'S LIFE      STOOLS PER DAY      COLOR OF STOOL
  1 to 2         1 to 2         blackish, tarry
  3 to 4         3 to 4         brownish-blackish
  4 to 6         4 to 6         brownish-yellowish
  6 to 30         8 to 10         yellowish
           (normally 1 after
           each feeding)
  30 and later   may be infrequent       yellow
           (up to 10-14 days
            without a stool)
  
* By the third or fourth day, does your baby have six or more wet diapers per day, with colorless or very pale urine?
  Since today's disposable diapers are so absorbent that they don't feel wet, you can check for urination by putting a piece of toilet tissue inside the diaper and then feeling that. Or pinch the bottom of the diaper; if the padding does not spring back to its original shape, the diaper is wet. Also, if it's wet it will feel heavy. Or you could use cloth diapers for the first few weeks. (You could let it be known that diaper service would be a wonderful baby present.)

Your Baby's Appearance and Behavior
  * Does your baby seem satisfied and content for an average of 2 to 3 hours between feedings in the first month or two?
  * In the first month or two, does your baby nurse 8 to 12 times in every 24-hour period, for 10 to 20 minutes on each breast?
  * After 3 days of age, when you open your baby's mouth during a nursing session, can you see milk inside and is the inside of your baby's mouth pink and moist?
  * Is your baby's skin soft and supple?
  * Does your baby have bright eyes and an alert manner?
  * By the third month is your baby nursing 6 to 8 times in a 24-hour period and seem contented for up to 5 or 6 hours, at least once during the 24 hours?

Your Baby's Weight
  * At your baby's first doctor's visit, was her initial weight loss less than 7 percent of birth weight? (Breastfed babies should normally have an office visit within 24 to 48 hours after early hospital discharge, then at 7 to 10 days of age, again at 3 weeks, and again at 6 weeks.)
  * Did your baby regain birth weight by two weeks of age?
  * Is your baby gaining an average of from 4 to 6 ounces a week (about 1/2 ounce a day) in the first month?

Your Nursing Experience
  * Can you hear swallowing sounds when your baby is at the breast, in a ratio of 1 or 2 sucks per swallow for the first five or ten minutes of nursing?
  * Do your breasts feel fuller before a feeding and softer afterwards?
  * When you nurse from one breast, does milk drip from the nipple of your other breast?   Can you feel the tingling of a let-down reflex as you begin to nurse? The presence of either of these signs affirms that your milk is flowing, but their absence does not mean that it is not.

NOTE: Do not test for hunger by offering your baby a bottle after a nursing. Many infants have such a strong urge to suck that they'll often take milk from a bottle even when they are not hungry. (Doing this may sabotage the course of breastfeeding, since some babies enjoy the ease of getting milk from a bottle and are less motivated to work a little harder at the breast. Furthermore, offering a bottle too soon can cause temporary nipple confusion, which you may need professional help to reverse.)